High speed pneumatic vitrectomy control

ABSTRACT

A method and system for controlling the cutting speed of a cutting device employable in an ocular surgical procedure is provided. The apparatus includes a control module, a variable gas pressure regulator arrangement configured to receive gas from a gas pressure supply, wherein the variable pressure regulator arrangement is connected to the control module and the control module is configured to regulate gas received from the gas pressure supply, and an accumulator configured to store gas received from the variable gas regulator arrangement at a selected gas pressure. Gas at the desired pressure is delivered from the accumulator to the cutting device. The gas may be air, and the variable gas pressure arrangement may include a single variable pressure regulator or multiple pressure regulators which typically are not variable with respect to the pressure delivered.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The present invention relates generally to the field of surgical repairof retinal disorders, and more specifically to pneumatic Vitrectomycutter power delivery during ophthalmic procedures such as the removalof vitreous gel.

2 Description of the Related Art

Vitrectomy surgery has been successfully employed in the treatment ofcertain ocular problems, such as retinal detachments, resulting fromtears or holes in the retina. Vitrectomy surgery typically involvesremoval of vitreous gel and may utilize three small incisions in thepars plana of the patient's eye. These incisions allow the surgeon topass three separate instruments into the patient's eye to affect theocular procedure. The surgical instruments typically include a vitreouscutting device, an illumination source, and an infusion port. Currentvitreous cutting devices may involve a “guillotine type action” where asmall knife is used to remove the vitreous gel. Vitreous cutters areavailable in either electric or pneumatic form. Today's electric cuttersmay operate within a range of speeds typically between 750-2500cuts-per-minute (CPM) where pneumatic cutters may operate within a rangeof speeds between speeds 400-2100 CPM. The surgeon or practitioner mayadjust to control, by selecting or varying, the pneumatic vitrectomysurgical instrument cutting speed, i.e. the cutting device within thehandpiece, sufficient to perform different activities during thecorrective procedure. Corrective procedures may include: maculardegeneration, retinal detachment, macular pucker, and eye injuries.

The cutting device within the handpiece requires precise control of thespeed of the cutting blade. Today's systems typically employ a constantor fixed frequency control signal to open and close the valve resultingin fixed cyclic valve timing and a fixed, relatively rapid cuttingspeed. Input supply pressure is varied to achieve a desired cuttingspeed.

Designs based on varying the input supplying pressure to control thespeed or rate of cutting are limited by how quickly the air volume inthe cutter body and the associated tube set may be pressurized to reachthe minimum peak pressure required to advance the cutter to a cutposition and then vent to reach the minimum residual pressure to allowthe spring-loaded cutter to return to a retracted position. Currentpneumatic designs are limited to cutting speeds within a range ofapproximately 400 to 2100 cuts per minute.

Today's vitrectomy surgical systems require a wide range of selectablecutting speeds and highly accurate control of the amount of air pressuresupplied to ensure proper instrument handpiece control and safe use inan operating theater. It may be beneficial in certain circumstances tooffer the surgeon variations in cutting speeds, controllability, andoptions related to performing a vitrectomy procedure. Based on theforegoing, it would be advantageous to provide a system that enablespneumatic cutting functionality at cutting speeds at or higher thanachievable with today's designs vitrectomy surgical instrument systemswith varying options in effectuating the highest desired cutting speeds.

SUMMARY OF THE INVENTION

According to one aspect of the present design, there is provided amethod for controlling a cutting device employed by an ocular surgicalsystem, such as a vitrectomy surgical system. The method comprisessupplying gas pressure to a variable gas pressure arrangement, providingfor selectability of a desired gas pressure value from the variable gaspressure arrangement based on a desired cutting speed for the cuttingdevice, storing gas at approximately the desired gas pressure value inan accumulator, and delivering gas pressure from the accumulator to thecutting device. The gas may be air, and the variable gas pressurearrangement may include a single variable pressure regulator or multiplepressure regulators which typically are not variable with respect to thepressure delivered.

According to a second aspect of the present design, there is provided anapparatus configured to control cutting speed of a cutting deviceemployable in an ocular surgical procedure. The apparatus comprises acontrol module, a variable pressure regulator arrangement comprising twoor more air pressure regulators sources configured to receive gas from agas pressure supply, wherein the variable pressure regulator arrangementis connected to the control module and the control module is configuredto regulate gas received from the gas pressure supply, and anaccumulator configured to store gas received from the variable regulatorarrangement at a selected gas pressure. Air volume is selectivelydelivered from the accumulator to the cutting device.

These and other advantages of the present invention will become apparentto those skilled in the art from the following detailed description ofthe invention and the accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

The present invention is illustrated by way of example, and not by wayof limitation, in the figures of the accompanying drawings in which:

FIG. 1A is high-level conceptual block diagrams to illustrate a commonvitrectomy system's pneumatic cutting mechanism, located within asurgical handpiece, with the pneumatic cutting mechanism in a “cut” or“forward” position;

FIG. 1B is high-level conceptual block diagrams to illustrate a commonvitrectomy system's pneumatic cutting mechanism, located within asurgical handpiece, with the pneumatic cutting mechanism in an “initial”or “backward” position;

FIG. 2A is a graph illustrating a typical cyclical control signal usedfor opening and closing a valve by setting the valve to either anenergizing or a de-energizing state;

FIG. 2B is a graph illustrating an output pressure waveform resultingfrom the control signal illustrated in FIG. 2A;

FIG. 2C is a graph illustrating the cyclical control signal applied to avalve where at a specific instance in time the frequency is increased;

FIG. 2D is a graph illustrating a pressure waveform resulting from thechange in the cyclical control signal frequency as illustrated in FIG.2C;

FIG. 3A is a block diagram illustrating components and devices for apneumatic vitreous cutting module integrated within aphacoemulsification machine;

FIG. 3B illustrates a handpiece used in the vitrectomy procedureintended to be used with the variable pressure pneumatic vitrectomycontrol;

FIG. 4 is a block diagram illustrating components and devices for a highspeed pneumatic vitreous cutting control module integrated within aphacoemulsification machine in accordance with one aspect of the presentinvention;

FIG. 5A is a block diagram that shows an example of the present designproviding input air pressure supply for driving a blade forward within avitrectomy handpiece;

FIG. 5B a block diagram that shows an example of the present designproviding output air pressure venting for driving a blade backwardwithin a vitrectomy handpiece;

FIG. 6 is a block diagram illustrating three pressure regulatorsarranged for selection to provide variable input air pressure supply;and

FIG. 7 is a block diagram illustrating an electronically variablepressure regulator configured to change the input air pressure supply.

DETAILED DESCRIPTION OF THE INVENTION

The following description and the drawings illustrate specificembodiments sufficiently to enable those skilled in the art to practicethe system and method described. Other embodiments may incorporatestructural, logical, process and other changes. Examples merely typifypossible variations. Individual components and functions are generallyoptional unless explicitly required, and the sequence of operations mayvary. Portions and features of some embodiments may be included in orsubstituted for those of others.

The present design provides a system and method for high-speed pneumaticvitrectomy control that may be used to precisely set and vary thecutting speed of the associated cutting blade mechanism over a widerange of operational speeds.

While the present design may be employed in various systems involvingcutting blades, it is illustrated herein in an exemplaryphacoemulsification—vitrectomy—diathermy system. It is to be understoodthat any type of system having supply air pressure control issues maybenefit from the design presented herein, and such a design is notlimited to a phacoemulsification—vitrectomy—diathermy system or even amedical system.

The present design is directed to accurate, reliable, and efficientcontrol of the forward and backward reciprocating motion cutting speedof the blade in a pneumatic vitrectomy handpiece used in a medicalinstrument system. The present design will be discussed herein with aparticular emphasis on a medical or hospital environment, where asurgeon or health care practitioner performs. For example, an embodimentof the present design is a phacoemulsification surgical system thatcomprises an integrated high-speed control module for the vitrectomyhandpiece. The surgeon or practitioner may adjust or set the blade speedvia a graphical user interface (GUI) module, a switch located on thehandpiece, or a foot pedal switch to control the high-speed pneumaticvitrectomy handpiece.

System

FIGS. 1A and 1B are high-level conceptual block diagrams to illustrate acommon vitrectomy system's pneumatic cutting mechanism located within asurgical handpiece. FIG. 1A shows the pneumatic cutting mechanism in the“cut” or “forward” position, while FIG. 1B shows the pneumatic cuttingmechanism in the “initial” or “backward” position. Referring to FIG. 1A,construction of today's pneumatic cutter devices typically involve ablade 110 positioned to work or operate against a spring 120 byinflating and deflating a bladder 130 configured to move blade 110 by‘pushing’ blade 110 forward to a forward position at 175 when bladder130 is inflated and ‘pulling’ blade 110 backward by the energy stored inspring 120 to its resting position or initial position 170 when bladder130 is deflated. The desired cutting speed may be realized by fillingand emptying bladder 130 in a cyclical manner through an air passage 140arranged for receiving a pressurized airburst in the direction indicatedat point 150. The received pressurized air burst is then evacuated orvented in direction 160. Current designs are generally configured tocyclically inflate and deflate bladder 130 to move blade 110 in aforward direction 180 and backward direction 190, thus producing thedesired cutting action. A combination input pressurized air supply andoutput air venting valve mechanism 195, or valve, is shown 195.

In order to control the speed of blade 110, currently availablepneumatic designs typically use a control signal to open and close valve195. Valve 195 may be configured to provide a pressurized airburst whenthe valve is open, i.e. control signal in the energized state, fillingbladder 130 and venting the air within bladder 130 when the valve isclosed, i.e. the control signal is in the de-energized state, to emptythe bladder. Increasing the frequency of the control signal cyclingrate, which produces a shorter pressurized air burst time, generallyresults in an increased cutting speed, or an increased number ofcuts-per-minute as observed at the knife. A subsequent decrease incontrol signal cycling rate generally produces a slower or decreasedcutting speed.

An example control signal to instruct the opening and closing of valve195 associated with air passage 140 is shown in FIG. 2A. The controlsignal illustrated in FIG. 2A may cycle between a valve-off (V_(O)) atpoint 210 to a valve-on (V_(E)) at point 220, or provide avalve-energized instruction at a predetermined cycling rate, therebyeffectuating the desired cutting speed. FIG. 2B illustrates an examplepressure waveform resulting from the application of the control signalshown in FIG. 2A. The waveform is shown to have a constant rise inpressure up to a peak pressure (P_(P)) at 230 when the valve isenergized. A subsequent drop in pressure to a residual pressure (P_(R))at point 240 occurs when the valve is de-energized. The cycling inpressure, for controlling the blade forward and backward reciprocatingmovements, as illustrated by the waveform shown in FIG. 2B, may producea specific cutting speed for blade 110 in terms of cuts-per-minute.

In addition, today's pneumatic cutter designs may be configured with aspeed control device to select and vary the rate the blade mechanismmoves forward and backward to effect cutting. In these designs, thespeed of the blade may involve changing or varying time or duration thecontrol signal provides to the valve. By increasing the time valve 195is open and closed, the resultant blade speed is reduced. Likewise,decreasing the time valve 195 is open and closed will cause the bladespeed to increase.

An example of a control signal for controlling the filling and emptyingof air in bladder 130 with an increase in cycle time is illustrated inFIG. 2C. Before time t₁ at 250, the control signal cyclic frequency isset at a lower rate than after time t₁ to illustrate the surgeonselecting an increase in cutting speed at time t₁ during a surgicalprocedure. FIG. 2D illustrates an example pressure waveform resultingfrom the application of the control signal shown in FIG. 2C. Thispressure waveform reflects the control signal change that occurred attime t1 at 250, and may drive blade 110 at a faster rate.

The pneumatic vitrectomy handpiece is used in connection with aphaco-vitrectomy module, illustrated in FIG. 3A, forming part of aphacoemulsification machine, and may include a guillotine type cutterpneumatically driven to either an open or closed position. Opening andclosing occurs via air pressure provided inside a flexible line ordelivery line between the cutter and a pneumatic driver. The pneumaticdriver may include a pump configured to fill a small reservoir withcompressed air at its maximum pressure capacity. The output of thisreservoir is connected to a pressure regulator that may regulate the airpressure down to the level required by the cutter, as shown by peakP_(P) and residual P_(R) pressure in FIG. 2B. A smaller reservoir may besupplied or fed by the regulator output, forming the source for thedelivery valve.

The electronic controller may be connected to the delivery valve and mayprovide instructions to produce a pulse width (in time) of pressurizedair when the valve is open. The controller may be arranged to providefixed pulses of pressurized air within the flexible line in a mannerthat drives the cutter. The electronic controller may use a fixed pulsetiming control signal to instruct the delivery valve to open and close.The fixed timing, or fixed duration, control signal instructs thedelivery valve to open and close in a constant cyclical manner. When theflexible line is at zero or near zero pressure, for example refer toresidual pressure P_(R) shown in FIG. 2B, the cutter is biased towardthe initial or resting position. The cutter closes when the air pressurein the cutter delivery line exceeds a predetermined value between P_(R)and P_(P). When the delivery valve is off, the air in the cutter tubingis exhausted through the valve exhaust port. The cutter then returns tothe initial position when the pressure in the delivery line decreasesclose to atmospheric pressure, i.e. P_(R).

FIG. 3A is a block diagram illustrating components and devices for aPneumatic Vitreous Cutting Module 305 integrated within aPhacoemulsification Machine 300. From FIG. 3A, a Compressed Air Source310 and associated Air Check valve 311 may supply air pressure forPneumatic Vitreous Cutting Module 305. The supply air pressure sourcemay be provided by a pump, not shown, that may receive air atatmospheric pressure and forms a vacuum or pressure source. Compressedair is provided by the pump via Delivery Line 301 illustrated betweenAir Check valve 311 and Pre-Regulator 312. Check valve 311 is arrangedwith two ports and may allow air pressure to flow through in onedirection, from Compressed Air Source 310 to Pre-Regulator 312. The pumpmay pump pressurized air into a high pressure chamber, not shown, whichin turn provides high pressure air to Pre-Regulator 312 via DeliveryLine 301. The high-pressure chamber, or compressed air source 310, mayconnect to the pump by a delivery line, not shown, and may provide astable source of air at a higher pressure than the working pressure ofthe cutter.

Pre-Regulator 312 may provide a workable steady air pressure stream fromwhich module 310 may supply air pressure for Pressure Regulator 313 viaDelivery Line 302. Pressure Regulator 313 may be preset, such as at 18psig, for example, and may be configured to provide air to Accumulator314 at a low-steady safe operating pressure. Pressure Regulator 313 mayconnect to Compressed Air Source 310, e.g. high pressure chamber, by adelivery line and take input high pressure and regulate the air pressureto a lower value consistent with the operating pressure of the cutterhandpiece. In this example Pressure Regulator 313 is set to 18 psig.

Accumulator 314 may operate as a working pressure chamber, and mayreceive pressured air at specific pressure and volume from PressureRegulator 313 via Delivery Line 303. Sensor 315 may monitor the pressurecoming from Pressure Regulator 313 by accessing Delivery Line 303.Sensor 315 may operate to determine the pressure in Delivery Line 303,located between Pressure Regulator 313 and Compressed Air Source 310 forthe purpose of sensing the level of air pressure or amount of airpressure available for Accumulator 314 and notifying the host system ifthe value is too high or too low. Accumulator 314 may provide a specificamount of air pressure at a predetermined volume to Delivery Valve 316via Delivery Line 304 so that no excess pressure is forced into theCutter Tubing 318.

PVD (Phaco-Vitrectomy-Diathermy) Controller 320, which may provide agraphical user interface, computes a cut rate based on physician inputand electronically provides the cut rate to Duty Cycle Controller 317via communications Control Line 306. Control Line 306 drives DeliveryValve 316 at the specified fixed time cyclical pulse rate viacommunications Control Line 307. Although depicted as an integral unit,module 305 functionality may be realized by using an external unit toperform the same functionality as disclosed for the integral unitdesign. Delivery Valve 316 may open and close in response to the controlsignal provided from Duty Cycle Controller 317. Duty Cycle Controller317 electronically controls the valves operating the regulated pressureand/or vacuum air sent to the cutter. The Duty Cycle Controller 317 mayconnect to Delivery Valve 316 to control Delivery Valve 316. Thehandpiece blade motion may move in a forward and backward reciprocatingmotion in response to the pressure waveform generated at 318.

During operation, Duty Cycle Controller 317 may operate Delivery Valve316 to deliver a pulse of regulated air pressure to Cutter Tubing 318and cutter (not shown). The pulses that drive the delivery valve 316have a fixed width of sufficient duration to drive the cutter to theclosed position throughout the entire range of operation. While thesurgeon or practitioner may select variations in the pulse repetitionfrequency, once the selection is made, the pulse width, or width of eachpulse, is uniform or constant during handpiece cutter operation.

Delivery Valve 316 is electronically controlled by Duty Cycle Controller317 to transmit pressure in a fixed pulse width and opens and closes ata precise time to allow air at a specific pressure and volume to fillthe Cutter Tubing 318 and operate the cutter. Delivery Valve 316 mayconnect to atmospheric pressure for purposes of venting Cutter Tubing318. Duty Cycle Controller 317 may receive instructions from PVDController 320, and may communicate electronically via communicationsControl Line 307. Controller 320 may provide an electronic indication toDuty Cycle Controller 317 that originates with a user selected switch,such as a switch on the handpiece, graphical user interface, or a footswitch.

FIG. 3B illustrates a handpiece used in the vitrectomy procedure thatmay be operated with the variable pressure pneumatic vitrectomy control.From FIG. 3B, Cutter Tubing 318 is positioned within an outer passageway352, and the handpiece 350 and pneumatics described above drive the endof cutter tubing 353 back and forth to cut vitreous material. The end ofCutter Tubing 318 current designs may involve a uniform inner and outerdiameter with the remainder of the Cutter Tubing 318 where the inner andouter diameter of Cutter Tubing 318 is uniform along the entire lengthof Cutter Tubing 318, including the end of Cutter Tubing 318.

High Speed Pneumatic Vitrectomy Control

The present design provides a method for controlling a cutting deviceemployed by an ocular surgical system, such as a vitrectomy surgicalsystem. Gas pressure is provided to a variable gas pressure arrangement,providing for selectability of a desired gas pressure value from thevariable gas pressure arrangement based on a desired cutting speed forthe cutting device, storing gas at approximately the desired gaspressure value in an accumulator, and delivering gas pressure from theaccumulator to the cutting device. The gas may be air, and the variablegas pressure arrangement may include a single variable pressureregulator or multiple pressure regulators which typically are notvariable with respect to the pressure delivered.

Alternately, the design may be considered to include an apparatusconfigured to control cutting speed of a cutting device employable in anocular surgical procedure. The apparatus comprises a control module, avariable pressure regulator arrangement comprising two or more airpressure regulators sources configured to receive gas from a gaspressure supply. The variable pressure regulator arrangement isconnected to the control module and the control module is configured toregulate gas received from the gas pressure supply, and an accumulatorconfigured to store gas received from the variable regulator arrangementat a selected gas pressure. Air volume is selectively delivered from theaccumulator to the cutting device.

FIG. 4 is a functional block diagram of an exemplary fixed timingvariable pressure pneumatic vitrectomy high-speed control module 405illustrating an arrangement of major components and devices required torealize the present design. This arrangement may use the pressure/vacuumgeneration equipment configured within a system such as thePhacoemulsification System 300. The major difference between the presentdesign and the previous example is the availability of more than oneselectable air pressure source, where each available pressure source isset to a different predetermined value.

From FIG. 4, the present design may involve a source of compressed air,and may regulated down the compressed air, ready for use to drive thevitrectomy handpiece (i.e. cutter). In this example, Compressed AirSource 310 may provide compressed air to Pre-Regulator 312 in the samemanner as previously described for the pneumatic vitrectomy controlexample. The present design may deliver compressed air fromPre-Regulator 312, via Delivery Line 402 a, to a Low Range Regulator 410and High Range Pressure Regulator 415 simultaneously. An input airpressure supply for each regulator is indicated as ‘B’ at 450. The LowRange Regulator 410 may be configured or preset to a value, for exampleat 18 psig, and the High Range Regulator 415 may be configured at 25psig. A Selector Valve 420 device may receive air pressure from both theLow and High Range Regulators and may be configured to switch betweenthe high and low pressure range based on control signals originatingfrom Fixed Pulse Electronics 425 via communications Control Line 407 b.Selector Valve 420 may switch the input source from High Range Regulator415 to the Low Range Regulator based on the desired cutting speedselected by the surgeon or operator. In this arrangement, the presentdesign may switch from a high-pressure input provided via Delivery Line402 c to a low-pressure input provided via Delivery Line 402 b whenhigh-speed cutting is selected. In this arrangement, for low-speedoperation, the high-pressure input source is used and the low pressureduring high-speed cutting. Fixed Pulse Electronics 425 may instructSelector Valve 420 to pass air pressure received on Delivery Line 402 cto Delivery Line 403.

In this example, Accumulator 314 may operate as a working pressurechamber, and may receive pressured air at a specific pressure and volumefrom Selector Valve 420 via Delivery Line 403. Sensor 315 may bearranged to monitor the pressure coming from Selector Valve 420 byaccessing Delivery Line 403. Sensor 315 may operate to determine thepressure in Delivery Line 403, located between Selector Valve 420 andAccumulator 314 for the purpose of sensing, the level of air pressure,or amount of air pressure available for Accumulator 314 and notifyingthe host system if the value is too high or too low. Accumulator 314 mayprovide a specific amount of air pressure at a predetermined volume toDelivery Valve 416 via Delivery Line 404 so that no excess pressure isforced into the Cutter Tubing 318.

PVD Controller 430, in this arrangement configured to interface with agraphical user interface, handpiece or foot pedal control switch,computes a cut rate based on physician input and electronically providesthe cut rate to Fixed Pulse Electronics 425 via communications ControlLine 407 a, which drives Delivery Valve 416 at the specified fixed timecyclical pulse rate via communications Control Line 407 a. Althoughdepicted as an integral unit, module 405 functionality may be realizedby using an external unit to perform the same functionality as disclosedfor the integral unit design. Delivery Valve 416 may open and close inresponse to the control signal provided from Fixed Pulse Electronics425. Fixed Pulse Electronics 425 electronically controls the valvesoperating the regulated pressure sent to the cutter. Fixed PulseElectronics 425 may connect to Delivery Valve 416 to control DeliveryValve 416. The handpiece blade motion may move in a forward and backwardreciprocating motion in response to the pressure waveform generatedthrough Cutting Tubing 318.

During operation, Fixed Pulse Electronics 425 may operate Delivery Valve416 to deliver a pulse of regulated air pressure to Cutter Tubing 318and cutter (not shown). The pulses that drive the delivery valve have afixed width of sufficient duration to drive the cutter to the closedposition throughout the entire range of operation. While the surgeon orpractitioner may select variations in the pulse repetition frequency,once the selection is made, the pulse width, or width of each pulse, isuniform or constant during handpiece cutter operation.

Fixed Pulse Electronics 425 may electronically control Delivery Valve416 to transmit pressure in a fixed pulse width and opens and closes ata precise time to allow air at a specific pressure and volume to fillthe Cutter Tubing 318 and operate the cutter. Delivery Valve 416 mayconnect to atmospheric pressure for purposes of venting Cutter Tubing318. Fixed Pulse Electronics 425 may receive instructions from PVDController 430 communicate electronically via communications ControlLine 406. PVD Controller 430 may provide an electronic indication toFixed Pulse Electronics 425 that originates with a user-selected speed,and may be entered via a switch on the handpiece, graphical userinterface, or foot switch.

The present design may control the selection of either a low or highrange air pressure supply depending on desired cutting speed input fromthe user. The combination of controlling Selector Valve 420 and Deliveryvalve 416 via Fixed Pulse Electronics 425 may enable the present designto operate, by varying the pressure or amount of air volume, over a widerange of cutting speeds not available with designs previously available.In this arrangement, the present design may control the amount ofpressurized air supplied to the handpiece by varying the supply pressureused based on the desired cutting speed or rate in cuts-per-minute. Thepresent design may involve lower air pressures such that the volume ofpressurized air required to be vented or evacuated is reduced, enablinghigher cutting rates as the pressure is lowered. The present design canreduce the time required to inject a volume of air needed to advancereciprocating motion of the cutter.

In summary, the present design may control the selector valve to supplythe cutter with either of two or more pressures from a variable pressuresource or two or more constant pressure sources. The present designentails controlling the delivery valve to either provide an air pressuresource or venting and evacuating the cutter tubing.

FIG. 5A is a block diagram that shows an example of the present designproviding input air pressure supply for driving a blade forward within avitrectomy surgical handpiece. In this example, the present design FixedPulse Electronics 425 may switch Selector Valve 420 to the appropriatepressure source in response to user provided cutting speed. The airreceived from the selected air pressure source is stored in anAccumulator 314 for purposes of driving the cutter. Fixed PulseElectronics 425 may instruct Delivery Valve 416 to open and close at apredetermined fixed cyclical rate. When Fixed Pulse Electronics 425instructs Delivery Valve 416 to open, the working supply air pressurestored in Accumulator 314 flows in the direction indicated at 530 athrough the valve and into the Cutting Tubing 318 as indicated at 530 b.

FIG. 5B a block diagram that shows an example of the present designproviding output air pressure venting for driving a blade backwardwithin a vitrectomy surgical handpiece. In this example, once the airpressure burst is supplied from Delivery Valve 416, Fixed PulseElectronics 425 may instruct Delivery Valve 416 to close. The airreceived from the previously delivered airbursts are vented or evacuatedfrom Cutting Tubing 318. Closing the delivery valve enables air pressureto flow in the direction indicated at 540 a from the cutting tubing backthrough Delivery Valve 416 and may continue to flow along Delivery Line521 in the direction indicated at 540 b to Muffler 520. Muffler 520 maythe vent the received air pressure to the atmosphere.

Fixed Pulse Electronics 425 may provide a set of fixed cyclicalinstructions to Delivery Valve 416 sufficient to open and close thevalve. Each time the present design cycles the valve to it's openedposition air pressure flows into the cutting tubing as shown in FIG. 5A.Once the valve has been held opened for the duration indicated by thecyclic instructions, a subsequent instruction commands the valve toclose and allow for air to vent through Muffler 520. Moving air pressurein this manner may enable the present design to move the cutting tubingforward and then backward in a cyclic reciprocating motion to effectvitreous material removal.

FIG. 6 is a block diagram illustrating three pressure regulatorsarranged for selection to provide variable input air pressure supply inaccordance with another aspect of the present invention. In thisembodiment of the present design, three regulators are illustrated,although any number of regulators, e.g. 4, 5, or 6, etc., may beaccommodated. In this configuration, Selector Valve 620 may switchbetween three pressure sources, for example high, medium, or lowavailable from either High Range Regulator 615 via Delivery Line 602 a,Mid Range Regulator 613 via Delivery Line 602 b, or Low Range Regulator610 via Delivery Line 602 c. Once the air pressure source is selected,air pressure received by Selector Valve 620 flows into Accumulator 314and delivered to Cutting Tubing in the same manner as previouslydescribed for the two-pressure regulator configuration. Fixed PulseElectronics 625 may communicate instructions to Selector Valve 620 viaControl Line 607 b and communicate instructions to Delivery Valve 416via Control Line 607 a in order to provide cutting tubing 318 with thedesired pressure waveform. The number of regulators involved may dependon the lowest and highest desired cutting rates.

FIG. 7 is a block diagram illustrating an electronically variablepressure regulator configured to change the input air pressure supply inaccordance with another aspect of the present invention. In thisembodiment, the present design may involve an electrically variablepressure valve to supply down regulated air pressure to Accumulator 314.In this configuration, Variable Pressure Valve 710 may vary the pressuresource through a wide range of pressure values. Once the air pressureset by the user, Fixed Pulse Electronics 725 may send instructions toVariable Pressure Valve 710 over communications Control Line 707 b toadjust the valve to required source pressure. Air pressure is suppliedby Valve 710 to Accumulator 314 via Delivery Line 703 and delivered toCutting Tubing 318 in the same manner as previously described for thetwo-pressure regulator configuration.

Fixed Pulse Electronics 725 may communicate instructions to SelectorValve 710 via Control Line 707 b and communicate instructions toDelivery Valve 416 via Control Line 707 a in order to provide cuttingtubing 318 with the desired pressure waveform. The supported pressurerange of Valve 710 may be determined depending on the lowest and highestdesired operational cutting rates.

User Interface

A user interface device executing within the Phacoemulsification System300 communicates with the PVD Controller and provide an input controlmechanism for the high-speed vitrectomy cutter. For example, a graphicaluser interface host system executing within system 300 may provideoperational control for the high-speed control mechanism. The userinterface device may include, but is not limited to, a touch screenmonitor, mouse, keypad, foot pedal switch, and/or a computer monitor.The system 300 may include algorithms and data relating desired cuttingspeed to required air pressure supply and cycle timing. The algorithmsand data may be resident within system 300 or realized using externaldevices and/or software. Graphical user interfaces are generally knownin the art, and the graphical user interface may provide, for example,touch screen or button selectability of desired pressure(s) by the usertouching the screen or pressing buttons on the interface. Other userinterfaces may be provided, such as a selection device including but notlimited to a foot pedal switch as discussed.

The design presented herein and the specific aspects illustrated aremeant not to be limiting, but may include alternate components whilestill incorporating the teachings and benefits of the invention. Whilethe invention has thus been described in connection with specificembodiments thereof, it will be understood that the invention is capableof further modifications. This application is intended to cover anyvariations, uses or adaptations of the invention following, in general,the principles of the invention, and including such departures from thepresent disclosure as come within known and customary practice withinthe art to which the invention pertains.

The foregoing description of specific embodiments reveals the generalnature of the disclosure sufficiently that others can, by applyingcurrent knowledge, readily modify and/or adapt the system and method forvarious applications without departing from the general concept.Therefore, such adaptations and modifications are within the meaning andrange of equivalents of the disclosed embodiments. The phraseology orterminology employed herein is for the purpose of description and not oflimitation.

1. A method for controlling a cutting device employed by an ocularsurgical system, comprising: supplying gas pressure to a variable gaspressure arrangement; providing for selectability of a desired gaspressure value from the variable gas pressure arrangement based on adesired cutting speed for the cutting device; storing gas atapproximately said desired gas pressure value in an accumulator; anddelivering gas pressure from said accumulator to said cutting device. 2.The method of claim 1, wherein providing for selectability furthercomprises providing for selectability between a lower value gas pressuresource for high-speed cutter operation and a higher value gas pressuresource for low-speed cutter operation.
 3. The method of claim 1, whereindelivering gas pressure occurs via a gas pressure valve, and deliveringgas further comprises providing gas volume to said cutting by releasinggas bursts from said accumulator when a gas pressure valve is open. 4.The method of claim 1, wherein delivering gas pressure occurs via a gaspressure valve, and delivering gas pressure further comprises returninggas volume from said cutting device by venting air pressure from saidcutting device when a gas pressure valve is closed.
 5. The method ofclaim 1, wherein delivering comprises providing a fixed pulse ratecontrol signal instructing the opening and closing of a gas pressurevalve.
 6. The method of claim 1, wherein the variable gas pressurearrangement comprises a plurality of gas pressure regulators.
 7. Themethod of claim 1, wherein the variable gas pressure arrangementcomprises a variable gas pressure regulator.
 8. The method of claim 1,wherein the gas comprises air and the cutting device is employed in avitrectomy device.
 9. An apparatus configured to control cutting speedof a cutting device employable in an ocular surgical procedure,comprising: a control module; a variable gas pressure regulatorarrangement configured to receive gas from a gas pressure supply,wherein said variable gas pressure regulator arrangement is connected tothe control module and the control module is configured to regulate gasreceived from the gas pressure supply; and an accumulator configured tostore gas received from the variable regulator arrangement at a selectedgas pressure; wherein gas at the selected gas pressure is delivered fromsaid accumulator to said cutting device.
 10. The apparatus of claim 9,wherein the cutting device receives gas from said accumulator when adelivery valve is open, and vents gas when said delivery valve isclosed.
 11. The apparatus of claim 9, wherein the variable gas pressureregulator source comprises a plurality of gas pressure regulators. 12.The apparatus of claim 9, wherein the control module comprises a sensorconfigured to monitor a gas pressure source value during operation ofthe apparatus.
 13. The apparatus of claim 10, wherein said controlmodule is configured to generate a fixed timing cyclical pulse waveformsignal to open and close said delivery valve.
 14. A method for varyingsource pressure applied to an ocular surgical device, comprising:setting a desired cutting speed for a blade employed with the surgicaldevice; enabling selection between at least two pressure values, whereinsaid enabling comprises: selecting a lower regulated gas pressure valuefor high-speed cutting; selecting a higher regulated gas pressure sourcefor low-speed cutting; and delivering gas at approximately a selectedgas pressure to the cutting device based on the desired cutting speed.15. The method of claim 14, wherein setting the desired cutting speedoccurs using a graphical user interface input device.
 16. The method ofclaim 14, wherein setting the desired cutting speed occurs using a footpedal switch input device.
 17. The method of claim 14, whereindelivering gas comprises providing air volume to said cutting device byreleasing gas bursts from an accumulator when a gas pressure valve isopen.
 18. The method of claim 14, wherein delivering gas comprisesreturning air volume from said cutting device by venting air pressurefrom said cutting device when a gas pressure valve is closed.
 19. Themethod of claim 14, wherein delivering further comprises generating afixed pulse rate control signal configured to result in selectivelyopening and closing a gas pressure valve.
 20. The method of claim 14,wherein the ocular surgical device comprises a vitrectomy device and thegas comprises air.